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IMPROVING HEALTH FOR VERY PRETERM CHILDREN IN EUROPE

Published articles

Variation in term birth weight across European countries affects the prevalence of small for gestational age among very preterm infants
Jennifer Zeitlin, Anna-Karin Edstedt Bonamy, Aurelie Piedvache, Marina Cuttini, Henrique Barros, Patrick Van Reempts, Jan Mazela, Pierre-Henri Jarreau, Ludwig Gortner, Elizabeth S. Draper, Rolf F. Maier and the EPICE Research Group
Acta Paediatr. (2017)


Intrauterine growth references are used for assessing the growth of very preterm (VPT) infants; a birth weight below the 10th percentile is considered to be small for gestational age (SGA). The aim was to assess the prevalence of infants classified as SGA using two different intrauterine growth references - country-specific and common European references - in 7766 VPT live births in the EPICE cohort.

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Evidence-based neonatal unit practices and determinants of postnatal corticosteroid-use in preterm births below 30 weeks GA in Europe. A population-based cohort study
Nuytten A, Behal H, Duhamel A, Jarreau PH, Mazela J, Milligan D, Gortner L, Piedvache P, Zeitlin J, Truffert P on behalf of the EPICE (Effective Perinatal Intensive Care in Europe) Research Group
PloS One (2017)


Postnatal corticosteroids (PNC) were widely used to treat and prevent bronchopulmonary dysplasia in preterm infants until studies showed increased risk of cerebral palsy and neurodevelopmental impairment. We found that PNC are still frequently used in Europe, but with wide regional variation that was unexplained by neonatal characteristics. Even for infants at highest risk for PNC use, some regions only rarely prescribed PNC. A stated policy of reduced PNC use was associated with observed practice and is recommended.

See full article here: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170234

Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in ten European regions
M Bonet, M Cuttini, A Piedvache, EM Boyle, PH Jarreau, L Kollée, RF Maier, DWA Milligan, P Van Reempts, T Weber, H Barros, J Gadzinowki, ES Draper, J Zeitlin, the MOSAIC and EPICE research groups
BJOG (2017)


Although the survival of infants born extremely preterm (before 27 weeks of gestation) has improved, the survival rates vary greatly across countries. This may reflect different policies for active treatment of these infants. The objective was to study mortality and morbidity in extremely preterm infants in relation to changes in maternity and neonatal unit policies in 10 European regions between 2003 and 2012, using data from the MOSAIC and EPICE cohorts.

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Patent ductus arteriosus treatment in very preterm infants: a European population-based cohort study (EPICE) on variation and outcomes
Edstedt Bonamy AK, Gudmundsdottir A, Maier RF, Toome, L, Zeitlin J, Bonet M, Fenton A, Børch Hasselager A, van Heijst A, Gortner L, Milligan D, Van Reempts P, Boyle EM, Norman M and collaborators from the EPICE Research Group
Neonatology (2017)


Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. We found that PDA treatment varies largely across Europen without associated variations in perinatal characteristics or neonatal outcomes. This finding calls for more uniform guidance for PDA diagnosis and treatment in very preterm infants.

See article here: https://www.karger.com/Article/Abstract/454798

Use of Magnesium Sulphate before 32 weeks of gestation: a European population-based cohort study
Wolf HT, Huusom L, Weber T, Piedvache A, Schmidt S, Norman M, Zeitlin J and the EPICE Research Group
BMJ Open (2017)


Magnesium sulphate has long been used in obstetric practice, but its current use is unknown. We aimed to explore reported policies of use of magnesium sulphate and the actual use in European obstetrical units by indication (eclampsia prophylaxis, fetal neuroprotection and tocolysis) in women giving birth before 32 weeks of gestation. We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort which is a large population-based multinational cohort.

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